"How I do it"--plastic surgery. Practical suggestions on facial plastic surgery. A modification of the Abbe-Estlander flap for defects of the lower lip.
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A mail survey was used to document the surgical methods for repair of cleft lip and palate being taught in Plastic Surgery Training Programs. The survey was completed by Senior Residents representing over 80% of the training programs in the United States. The results demonstrate that variation exists regarding methods and techniques for cleft lip and palate surgery.
BACKGROUND: According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, during the last 7 years, the number of abdominoplasty procedures performed has increased 344 percent. A national report on abdominoplasty has not been since 1977. Grazer and Goldwyn's study reflects the preliposuction era of abdominal contouring surgery. The purpose of this study was to assess current trends in abdominal contouring techniques and associated procedures and the incidence of their complications. METHODS: The study was designed as a descriptive correlation survey evaluating the frequency of various abdominal contour techniques and complications among 3300 randomly chosen members of the American Society of Plastic Surgeons. There were 497 respondents, for a response rate of 15 percent. RESULTS: A total of 20,029 procedures were reported in the survey; 35 percent (n = 7010) were liposuction of the abdomen, 10 percent (n = 2003) were limited abdominoplasties, and 55 percent (n = 11,016) were full abdominoplasties. Survey data covered the plastic surgeon's demographics, techniques, and incidence of complications during a 12-month period. CONCLUSIONS: The authors report the largest series of local and systemic complication rates and compare them with those of previously published abdominoplasty surveys. With respect to full abdominoplasty, lower complication rates for deep vein thrombosis (0.04 percent) and pulmonary embolus (0.02 percent) were seen. No deaths were reported. There was no correlation between a surgeon's years in practice and complication rates, in concordance with the earlier study by Grazer and Goldwyn. Despite more extensive abdominal contouring techniques and the addition of liposuction to abdominal contouring, the local and systemic complication rates coincided with previous complication rates, as outlined in other studies.
Pediatric plastic surgery has seen widespread advances during the past decade. These have been primarily in the biologic understanding of certain disease processes as well as in diagnostic and therapeutic technologies. These advances have contributed to a potential new array of treatment options for congenital deformities and traumatic injuries. This review identifies several of the most significant new trends and treatment concepts in pediatric plastic surgery from anesthesia to wound healing.
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A moderate size tumor of the nasal tip and dorsum is excised and the large defect is primarily reconstructed with local flaps without obliteration of natural convexities and concavities. This is achieved by judicious utilization of numerous techniques. The techniques utilized are a V to Y advancement that produce a partial mobilization of the nasal dorsal skin, a full reduction rhinoplasty that dropped the nasal bony roof allowing for further mobilization of the nasal dorsal skin and allowed for tip elevation. A third technique that was utilized was a Z plasty as applied to correction of raised webs. The excess dorsal skin was converted into the needed length to close the tip defect. The patient tolerated this procedure well. His postoperative course was without complications. Postoperative results were good, but there was some persistent tip elevation that perhaps gave him a too youthful appearance for his age (Fig. 2). A novel use of V to Y advancement, Z plasty, and reduction rhinoplasty is described when used concurrently to primarily close a defect of the nasal tip and dorsum.